Friday, August 26, 2016

We have had working health insurance coverage for the past couple of years (unlike in 2014), but now we have moved and need to change the billing address.

I go to the Vermont Health Connect web site and click "Report a Life Change" to learn: "These changes should be reported by calling Vermont Health Connect toll-free at 1-855-899-9600 or by logging into your account and reporting your change online." I log in with the result: "An unexpected error occurred. Please contact an administrator." And "Contact Us: Have questions or want to find out more? Tel: (855) 899-9600."

I call. I wait. I give up. I call again a couple days later, wait, give up. I call again and add my number to a queue to be called back "within 3 business days". [Update: One week later, no callback.]

[Update, Sept. 12: Two weeks later, no callback. The web site now says that one can report "life changes" on line. So I logged in to my account (trying Opera after receiving the message that "There was some technical error processing your request" in Firefox, and then in Opera being forced to reset the password), got to the irritating terms page, and clicked "Next" — to receive the message that "An unexpected error occurred. Please contact an administrator." Called: "Estimated wait time is greater than 90 minutes." Left another request for callback (an option that is offered only after a couple minutes of waiting).]

[Update, Sept. 23: They called back! But we were out. That was on Sept. 15. Nothing since. Governor Shumlin defended the whole mess yesterday: "nearly 9 in 10 customers seeking to report a life change 'experience a smooth process,' he said." So I went on line again to report my change of address, and now I couldn't even log in. So I called again (to set up another callback). One of Shumlin's improvements appears to have been to no longer provide an estimated wait time, and after a few minutes there was no longer an option to request a callback. I was planning to wait 5 minutes, and just before that cut-off, someone answered! They have our new address!]

[Update, Oct. 21: This month's premium notice was sent to our old address. I called VHC (no wait at all!) to confirm that they have the new one, which they do, so maybe it will arrive correctly next month.]

Meanwhile, this month's premium invoice was sent to our old address and instead of being forwarded to us by the Post Office it was returned to Vermont Health Connect who then sent it to our new address with a note about changing the address. We at last received it 1 day before payment was due.

So I called the telephone number provided with the invoice for credit/debit card payment. I should not have been surprised to learn that here, too, "current wait times are 90 minutes".

So I will send the premium payment by mail, trust the assurances from last year that there is a 90-day grace period before coverage is cancelled and current implications that a change of address does not require a complete new application. One also hopes that the address change manages to be made before next month's premium invoice goes out.

Again, before the "Affordable Care Act", so-called Obamacare, Vermont had an excellent functioning state-run health insurance program that through an income-based range of premiums provided near-universal coverage. It wasn't perfect, but it was a system that made living in Vermont very worthwhile. To improve on it, the state had long pursued a true universal single-payer system, electing Peter Shumlin as Governor in 2006 on the promise to implement it. Because of Shumlin's belief, however, that people could not handle the information that they would pay taxes for health insurance instead of paying more in premiums to private insurers whose business is to deny care, the details – and final legislative action – were continually postponed.

Then came Obamacare in 2010, with no provision for states with better systems to keep them. There was no effort by Shumlin or the state's Congressmembers to protect Vermont's system. So money and effort had to be spent to set up the "Obamacare Exchange" (which still doesn't work), and delays and ballooning expenses were justified by the 2-track project of preparing for the coming single-payer system. On May 26, 2011, Shumlin had signed the bill to enact single-payer health insurance.

Finally, Shumlin was re-elected (barely) in 2014 for a third term on the promise that the final plan was to be revealed in December (after the election). Instead, on December 17, he announced that single-payer was dead. It was dead because he was never ready to fight for the payroll taxes to pay for it. He pretended that the need for those taxes was a new discovery, but it was well known from the beginning that such taxes would be the means of funding it. Public advocacy groups had long been explaining to people that the new taxes would be substantially less than current premiums, but the state took no part in that information program. Business owners praised Shumlin, and a few months later he endorsed Hillary Clinton for President and then that he would not seek re-election in 2016.

Shumlin was elected to enact single-payer health insurance in Vermont. Instead, he killed it. Never trust a Democrat.

[Update, Oct. 24: “Obama administration announces double-digit premium hikes for Affordable Care Act” (PBS News Hour): ‘Before taxpayer-provided subsidies, premiums for a midlevel benchmark plan will increase an average of 25 percent across the 39 states served by the federally run online market, according to a report from the Department of Health and Human Services. … Moreover, about 1 in 5 consumers will only have plans from a single insurer to pick from, after major national carriers such as UnitedHealth Group, Humana and Aetna scaled back their roles. … While many carriers are offering a choice of plan designs, most use a single prescription formulary and physician network across all their products, explained [Caroline Pearson of the consulting firm Avalere Health]. “So, enrollees may need to change doctors or drugs when they switch insurers,” [s]he said.’ (Our premium is going up 10%. [Update, October 2017: premium for 2018 going up another 10.8%.])]

[Update, Dec. 14: The first bill for 2017: The amount due has increased by 291%! For no apparent reason, the "advanced premium tax credit" (APTC) was slashed to 38% of what it was throughout 2016, despite the renewal notice dated Dec. 7 stating that it would actually go up. I called and waited 10 minutes and was told that the new amount is what I accepted of the new year's APTC. There was no record of when I did that (because I never did). I arranged to accept quite a bit more of the APTC that we are eligible for, so that the monthly premium will now actually be less that the past year's, but I was also told to go ahead and pay the current bill and hope that the extra will be credited ...]

[Update, Dec. 20: A second first bill for 2017, dated 8 days after the first one (see previous note) arrived, but now with the amount due increased 18% from last year. It does not reflect the APTC that I arranged to accept (see previous note), so it is only adding to the confusion and one more thing to hope: that ignoring this superfluous bill won't cause trouble.]

[Update, Dec. 21: A second renewal notice for 2017, dated 12 days after the first one (see two notes above) arrived: nothing different from the first one (though slightly different formatting), just more waste and confusion.]

[Update, Dec. 27: Notice of partial premium payment. Which in fact was an overpayment (see three notes above). Isn't this fun.]